Emergency Scenario 900_f2

Location Information

Full Location:

Heimagata 5, 900 Vestmannaeyjar, Single-story residential house built in 1965. Main entrance is at the front of the house. No stairs. Street parking available. No security features. Current conditions: 10°C, partly cloudy, good visibility. GPS coordinates: 63.4412° N, 20.2698° W. Nearest landmark: Vestmannaeyjar Golf Club.

Municipality: Vestmannaeyjar

Postal Code: 900

Emergency Details

Type: Allergic Reaction

Priority Level: F2

Response Time Goal: Urgent (15-30 minutes)

Description:

35-year-old female, experiencing severe allergic reaction after eating shellfish. Primary symptoms: Rapid onset of dyspnea, facial angioedema, generalized urticaria, and audible wheezing. Secondary symptoms: Dizziness, anxiety. Patient is conscious but distressed. Medical history: Known shellfish allergy, carries an epinephrine auto-injector (EpiPen). Medications: None regularly. No recent healthcare contacts. Last meal was shellfish approximately 30 minutes ago.

History of Events

Timeline:
1400 hours: Patient consumed a seafood dish containing shellfish.
1415 hours: Patient started experiencing itching and hives.
1420 hours: Patient developed significant swelling of the face and lips, difficulty breathing, and wheezing. 
1422 hours: Patient self-administered EpiPen.
1425 hours: Symptoms are still worsening. Patient is increasingly distressed, and daughter called emergency services.
1427 hours: Current time, patient is conscious but struggling to breathe.

Prior Events: Patient has a documented history of shellfish allergy and has previously used an EpiPen. No recent illnesses or injuries. Last medical check-up 6 months ago, routine follow-up.

Diagnostics

Initial Assessment

Initial Impression: Severe Anaphylactic Reaction
Justification for F2 Classification:
- Rapid onset of symptoms following known allergen exposure
- Presence of airway compromise (dyspnea, wheezing, angioedema)
- Potential for rapid deterioration and life-threatening condition
- Patient has used EpiPen, indicating severe reaction history

Differential Diagnoses:
1. Anaphylaxis due to shellfish (high probability)
2. Severe allergic reaction (less likely given speed and severity)
3. Angioedema (less likely without allergen exposure)
4. Asthma exacerbation (less likely given history)

Required Actions:
- Dispatch of ground EMS with ALS capabilities
- Oxygen administration and airway support
- Second dose of epinephrine if needed and available
- Monitoring of vital signs and level of consciousness
- Preparation for rapid transport to hospital with allergy management capabilities

Final Diagnosis

Final Diagnosis: Anaphylaxis due to Shellfish
Key Findings:
- Patient responded partially to initial epinephrine dose but required additional medical intervention.
- Physical examination confirmed severe angioedema, urticaria, and wheezing.
- Patient's oxygen saturation was low, requiring supplemental oxygen.
- No other injuries or conditions were identified.

Outcome validated F2 priority assignment. Rapid dispatch and medical intervention were crucial in stabilizing the patient. Patient was admitted to hospital for observation.

Learning Points:
1. F2 classification was appropriate due to the severity and rapid progression of symptoms.
2. Initial assessment accurately identified anaphylaxis, and prompt epinephrine administration was life-saving.
3. Continued monitoring and transport to hospital were essential for ongoing management of the reaction.

Emergency Call Transcript

Dispatcher Emergency services, what's your emergency?

Caller My mother is having a very bad allergic reaction! She can't breathe!

Dispatcher Okay, I'm sending help. What is your address?

Caller It's Heimagata 5 in Vestmannaeyjar.

Dispatcher Help is on its way. Can you tell me what happened?

Caller She ate some seafood and now she is swelling up and can't breathe. She is wheezing!

Dispatcher Has she used her EpiPen?

Caller Yes, she did, about 5 minutes ago, but it's not helping much.

Dispatcher Is she awake and talking to you?

Caller Yes, she's awake but she's very scared and struggling to breathe.

Dispatcher Does she have any other medical conditions?

Caller She is allergic to shellfish. That's why she has the EpiPen.

Dispatcher Okay, the ambulance is on its way. Stay with her and try to keep her calm. Do not give her anything to eat or drink.

Caller Okay, thank you. I will wait here with her.